Organization
MIDWEST ENT ALLIANCE PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NIRAV THAKKAR MD (AUTHORIZED OFFICIAL)
(708) 460-0007
Entity
Organization
Contact information
Practice address
16001 108TH AVE, ORLAND PARK, IL 60467-8788
(708) 460-0007
Mailing address
16001 108TH AVE, ORLAND PARK, IL 60467-8788
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
—
—
Other
Enumeration date
08/29/2023
Last updated
08/29/2023
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